Case Manager Job, Full Time, Primary Care

Sanitas Medical Center is hiring a Full Time Case Manager for our Memphis - Crosstown facility in Memphis, TN. 

The Case Manager works with members, providers, and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum. The primary contact with the patient, family and other involved care providers will be by telephonically, all events will be documented in the electronic medical record (EMR).

This full-time Case Manager position is located in our Memphis - Crosstown facility in Memphis, TN.  The Case Manager plays an important role in customer service inside and outside the facility, in addition to conducting initial review of members data provided by health plan; to determine which HRA must be completed (Medicare Initial HRA and/or Annual HRA).

Benefits: 

Medical, Dental, and Vision Insurance 

Paid Time Off 

Life & AD&D Insurance 

Disability Insurance 

Employee Assistance Program (EAP) 

Voluntary Benefits 

Case Manager Roles and Responsibilities:

Conducts initial review of members data provided by health plan; to determine which HRA must be completed (Medicare Initial HRA and/or Annual HRA).
Compare against members self-reported data obtained through the Health Risk Assessment (HRA) process (if applicable).
Conducts comprehensive health risk assessment to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment per regulated timelines.
Interacts telephonically with member to initiate members individualized care plan using the available data based on HRA.
Prioritizes members according to intensity, need, and required follow-up mitigating immediate needs prior to visit with primary care provider.
Provide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and religious, developmental, health literacy, and educational backgrounds of the population served.
Assess the patients formal and informal support systems, including caregiver resources and involvement as well as available benefits and/or community resources.
Assesses for barriers to care, provides care coordination and assistance to member to address psycho/social, financial, and medical obstacles concerns, avoiding duplication of services.
Facilitates comprehensive assessment summary for primary provider review and formulation of care plan.
Provide education, information, direction, and support related to care goals of patients.
Act as a patient advocate and assist with problem solving and addressing any barriers to care or compliance with care plan.
Maintain accurate patient records and patient confidentiality.
Measure outcomes and effectiveness of case management including clinical, quality of life and patient/family satisfaction.
Promote chronic disease management concepts, health screening and preventive health initiatives for targeted patients.
Facilitate disease prevention and health promotion with patients and family while promoting patient and family responsibility and self-management.
Troubleshoots problems regarding operational and clinical procedures that may affect patient outcomes.
Complies with all requirements of the Care Management Model of
Document all relevant information following department policy guidelines.
Maintain knowledge of operational procedures and case management program components.
Maintains knowledge of and compliance with current Medicare/Medicaid, state/federal rules.
Ensures compliance with the Medicare conditions of participation and other state regulations govern the provision of healthcare.
Complies with all Health Insurance Portability and Accountability Act (HIPAA) requirements in accordance with federal, state, and organizational policies.
Assumes responsibility for personal growth. Develops, maintains, and upgrades professional knowledge and practice skills through attendance at seminars, conferences and participation in continuing education and in-service classes.
Able to perform duties autonomously, schedule and meet workload expectations
Note for RN's: May have additional duties, such as providing consultation, recommendations and education as appropriate to non-RN case managers; working cases with members who have complex medical conditions and medication regimens; and/or conducting medication reconciliation when needed..
Required Education and Experience

1. Completion of an accredited Registered Nurse (RN)
2. 1-3 years in case management, disease management, managed care or medical health settings
3. 13-year experience working with Medicare population (preferred)
4. Active, unrestricted State Nursing license (RN) license in good standing
5. Active and unrestricted Certified Case Manager (CCM) or Social Worker License.

Knowledge, Skills and Abilities:

• Knowledge and skill in chronic disease management
• Excellent verbal and written communication (including documentation) skills
• Excellent relationship management with patients, families, and care providers
• Professional demeanor
• Ability to work as a member of a team
• Ability to organize and prioritize tasks
• Ability to promote/participate in patient centered medical home mode of care
• Exceptional customer service skills and understanding of patient and family centered care concepts
• Strong organizational skills

About Sanitas Medical Center 

We are a global leader in patient care. Join an organization dedicated to quality patient care, research and education with operations in 8 countries, serving close to 3 million people and more than 14,000 health care employees. 

 

At Sanitas, you will find a supportive, team-oriented culture that fosters innovation and respects different points of views empowering each employee to do what’s in the best interest of our patients. We offer a competitive compensation program to help you meet your personal and financial goals, grow your career, safeguard your health and secure your future. 

 

We prioritize nurturing a socially conscious corporate culture that values employee development and rewards innovative thinking—apply today.